视网膜静脉阻塞激光光凝的时机选择

Timing of retinal vein occlusion laser photocoagulation

摘要:

目的：观察激光光凝治疗不同病程的视网膜静脉阻塞(retinal vein occlusion，RVO)的临床疗效，探讨RVO激光光凝治疗的时机，为临床选择RVO光凝治疗时机提供依据。

方法：回顾性分析视网膜激光光凝治疗的RVO患者103例103眼，按发病时间将患者分为3组， A组46眼，病程≤1mo，其中视网膜分支静脉阻塞(branch retinal vein occlusion，BRVO)28眼，视网膜中央静脉阻塞(central retinal vein occlusion，CRVO)18眼； 缺血型RVO 30眼，非缺血型RVO 16眼。B组38眼，1mo<病程<3mo，其中BRVO 22眼，CRVO 16眼； 缺血型RVO 26眼，非缺血型RVO 12眼。C组19眼，病程≥3mo，其中BRVO 7眼，CRVO 12眼； 缺血型RVO 15眼，非缺血型RVO 4眼。随访3mo，观察光凝治疗后各组患者的视力变化差异、视网膜出血、眼部新生血管、黄斑中心凹厚度下降值。

结果：不同病程RVO光凝治疗后患者的最佳矫正视力提高率，视网膜出血、黄斑水肿吸收情况，黄斑中心凹厚度降低量，早期组优于晚期组，非缺血型RVO优于缺血型RVO，激光光凝治疗效果BRVO优于CRVO且差异具有统计学意义(P<0.05)。

结论：RVO早期激光光凝干预治疗，可以加速视网膜出血、黄斑水肿吸收，有效保护患者现有视力、促进远期视力提高，具有一定临床实用意义。

Abstract:

AIM:To observe the clinical curative effect of different duration of retinal vein occlusion(RVO)by laser photocoagulation treatment, discuss the timing of the RVO laser photocoagulation treatment, provide the basis for clinical choice of RVO photocoagulation treatment time.

METHODS: Retrospective analysis. Line selection retinal laser photocoagulation treatment for 103 cases(103 eyes)with RVO, patients were divided into three groups according to the onset time. In group A(46 eyes), course ≤1mo, 28 eyes with branch retinal vein occlusion(BRVO), 18 eyes with central retinal vein occlusion(CRVO); 30 eyes were ischemic RVO, 16 eyes were non-ischemic RVO. In group B(38 eyes), 1moRESULTS: The best corrected visual acuity improved rate, retinal hemorrhage, macular edema, absorption, macular center concave thickness decreased of patients with different course after RVO photocoagulation treatment, the early group was better than that of the late, non-ischemic RVO was better than that of ischemic RVO, laser photocoagulation treatment effect BRVO was better than that of CRVO and the difference was statistically significant(P<0.05).

CONCLUSION: RVO laser photocoagulation in the early intervention treatment can accelerate the retinal hemorrhage, macular edema, absorption, effectively protect the patient's existing vision, improve the long-term vision, and has a certain clinical practical significance.